It will take political will to enact long-term systemic changes that promote gender equality and remove barriers.

The Global Health Initiative, introduced by President Barack Obama in the summer of 2009, is a central pillar of U.S. foreign policy. The ambitious multi-billion dollar program seeks to achieve significant health improvements and foster sustainable, effective and efficient public health programs that deliver essential care to some of the poorest regions in the world.

The Global Health Initiative targets maternal and child health, with a strong emphasis on preventing maternal mortality. That is because by improving the health of the woman, who is the center of the family, we improve the health of the family, and of the entire community. Improved access to and use of family planning and reproductive health services, a safe birthing environment, skilled attendance at birth, and strong health care systems are all critical to diminishing the rate of maternal mortality.

“Family planning counseling is a critical part to prevent the next unplanned pregnancy,” said Dr. Douglas Laube, a former Jefferson fellow at the U.S. Agency for International Development’s Office of Population and Reproductive Health. “It’s estimated that there could be a 25 to 35 percent reduction in maternal mortality just through the use of meaningful contraception.”

Approximately 99 percent of maternal deaths occur in developing countries, most of them within 24 hours of delivery. The most common causes of maternal death are severe bleeding, infection, obstructed labor, and hypertensive disorders, such as eclampsia. These causes are largely preventable: once detected, they are often treatable at relatively low costs.

So why does maternal mortality remain one of the leading causes of death among women of reproductive age in developing countries? Weak health systems and shortages of trained health care providers certainly contribute high maternal mortality rates. Gender discrimination further exacerbates the problem, including the low status of women caused by misogyny, says Dr. Laube:

“Women don’t have a chance. They don’t count. . . . Misogyny kills women in two ways: directly through violence, and indirectly through neglect."

Through the Global Health Initiative which is implemented by agencies across the U.S. government in partnership with Ministries of Health, we are working to change such practices. But in the end, it will take political will to enact long-term systemic changes that promote gender equality and remove barriers to quality health services for women—so that no woman in the world should die giving birth.